Provider Demographics
NPI:1508302407
Name:VENAGLIA, SARA (CNA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:VENAGLIA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 W MARIPOSA
Mailing Address - Street 2:APT 2
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-6422
Mailing Address - Country:US
Mailing Address - Phone:804-837-3441
Mailing Address - Fax:
Practice Address - Street 1:149 W MARIPOSA
Practice Address - Street 2:APT 2
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-6422
Practice Address - Country:US
Practice Address - Phone:804-837-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula